Medical Group Liaison Specialist

3 weeks ago


Chicago, Illinois, United States w3r Consulting Full time

We are seeking a highly skilled Medical Group Liaison Specialist to join our team at w3r Consulting. This is a dynamic position that requires strong analytical, verbal, and written communication skills.

About the Job

As a Medical Group Liaison Specialist, you will be responsible for ensuring compliance with utilization management (UM) and quality review (QR) standards for medical groups participating in our networks. You will also design and implement educational seminars to promote the UM/QR process.

Responsibilities:

  • Review and evaluate UM/QR plans for prospective and existing medical groups
  • Communicate contractual requirements to medical groups, IPAs, and contract management firms
  • Monitor UM activities of medical groups to measure adherence to HMO UM/QR standards
  • Oversee the development and implementation of corrective action plans for deficient medical groups
  • Design and implement in-services, seminars, and special presentations to promote the UM/QR process

Requirements:

  • Registered Nurse (RN) with unrestricted license
  • 3 years clinical experience with 2 years experience in utilization review, quality assurance, or statistical research
  • Clinical knowledge, knowledge of the UM/QR process, and knowledge of managed care principles
  • Analytical, verbal, and written communication skills

Estimated Salary: $83,000 - $113,000 per year, depending on experience and qualifications.



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